**1. Introduction**

Stroke is one of the major health care problems in the world today. It is the third leading cause of mortality in the western countries and the most common cause of mortality of any neurological disorder. Incidence of stroke is 160 per 100,000 population per year; 40 percent of victims require some type of special services and 10 percent require total care. [1, 2] Consequently, stroke rehabilitation places a large drain on national health care resources.

A significant proportion of strokes are ischemic in nature, one of leading causes for which is internal carotid artery (ICA) atherosclerosis. It is estimated that 20-25 percent of all strokes can be attributed directly to carotid bifurcation atherosclerosis. [1, 2]

Both internal carotid artery endarterectomy and carotid stenting in patients with preopera‐ tive ocular or cerebral embolic events are well established as procedures that reduce the risk of future ischaemic events. [3-7] In addition to the management of hypertension and commencement of antiplatelet and statin therapy, these interventions form the corner stone of stroke prevention policy in patients with significant ICA stenosis. As it is recognised that a significant proportion of patients have a disabling embolic stroke attributable to severe ICA stenosis without any prior symptoms, [8, 9] it would be advantageous if patients who are at highest risk of stroke from ICA stenosis could be identified and treated in advance of any ischaemic neurological events.

© 2014 Mofidi and Green; licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
